Adult Autism Assessment in New York & Connecticut: What to Expect from an Affirming Evaluation

Most adults who come to me suspecting they are Autistic have already done a great deal of reading. They are not looking for an introduction to the topic. They want to know whether this explains a specific set of things about their life — the exhaustion after ordinary socializing, the sound of a restaurant being unbearable, the sense of running a simulation of a person all day.

Why so many adults were missed

Autism was diagnosed almost exclusively in children for decades, and the criteria were shaped around how it presents in young boys. Adults who did not fit that template — women, nonbinary people, people of color, and anyone who got good at masking early — were simply never identified. A lot of them collected other labels along the way: anxiety, depression, ADHD, a personality disorder, or the informal ones, too sensitive, socially awkward, difficult.

The reasons people give me for seeking an assessment now:

• A lifelong sense of being out of step that has never had a good explanation
• Sensory experiences — light, sound, texture, crowded rooms — that are genuinely painful, not merely annoying
• Exhaustion after socializing, and no instinct for the rules everyone else appears to have absorbed
• Deep, absorbing interests that are among the best parts of your life
• Burnout that has been building for years from the effort of appearing normal
• A family member's diagnosis that made you recognize yourself in the description
• Treatment for anxiety or depression that helped somewhat and never touched the actual thing

What "affirming" means here

It does not mean I will tell you what you want to hear. It means the assessment is built to describe how you are wired — sensory experience, communication style, what you need socially, what your brain does well — rather than to tally where you deviate from a norm.

Practically, that means:

• Autism is treated as a difference in nervous system architecture, not a defect to correct
• Masking is taken seriously, including the fact that it hides Autism from conventional assessment
• You do not have to perform distress to be believed, and you do not have to perform competence either
• The output is self-understanding and usable support, not a label filed away somewhere

How the assessment works

Everything happens by secure video and it usually takes about three sessions, built around the MIGDAS (Monteiro Interview Guidelines for Diagnosing the Autism Spectrum) interview plus standardized questionnaires.

The MIGDAS interview

The MIGDAS is a sensory-based interview conducted as a conversation. Conventional instruments largely score what a clinician can observe from the outside, which is exactly the wrong approach for an adult who has spent thirty years learning to manage what they show. The MIGDAS asks about the inside: how you actually process sound and texture and light, what social interaction costs you, how you communicate when you are not monitoring yourself.

That is why it works for adults who mask. It is asking about the part masking conceals.

Standardized questionnaires

Alongside the interview, you complete validated measures covering sensory processing and social communication. They give a second source of data so the conclusion does not rest on one conversation.

Feedback

We go through what came out of it, whether Autism is present, and what to do with the information — accommodations, strategies, and where to push back on demands that have been quietly costing you more than they should.

Virtual assessment across New York and Connecticut

I run these for adults anywhere in New York or Connecticut, entirely over video.

For many Autistic adults, video is not a lesser option — it is the better one. An unfamiliar building, a waiting room, fluorescent lighting, and a stranger's office are a sensory tax, and paying it right before an interview about your sensory experience is a poor arrangement. From your own space, with your own lighting and your own chair, you get to be more accurate about yourself.

Who should consider it

An assessment is worth considering if this sounds like your life:

• Socializing feels like a performance you are running rather than something you are simply doing
• Noise, crowds, certain fabrics, and bright light affect you far more than they seem to affect other people
• You need routine and advance warning, and unannounced changes cost you the rest of the day
• You have interests you can disappear into for hours, and switching tasks is genuinely difficult
• Even good social time leaves you flattened
• You have been told you are too much, or not enough, for most of your life
• You carry a diagnosis of anxiety, depression, or ADHD and something central is still unexplained

Autism and ADHD together

These two overlap constantly. Plenty of adults arrive with an ADHD diagnosis already in hand and learn during the evaluation that Autism is also in the picture. I assess both, which matters, because the combination creates contradictions that are baffling if you only know about one of them — needing novelty and needing sameness, at the same time, in the same person.

If you cannot tell whether Autism or ADHD or both explains your experience, that is a question an evaluation is designed to answer. There is also a separate guide on adult ADHD signs if that is where you want to start.

Why work with me

• Affirming by design. Autism described as a difference, with the assessment built accordingly.
• MIGDAS. I use the MIGDAS interview, which is made for conversational, affirming assessment.
• Narrow focus. ADHD, Autism, OCD, and parent coaching, not general practice.
• Lived experience. I have ADHD and I am raising neurodivergent kids.
• Licensed in NY and CT. Adults in both states, by secure video.
• No unfamiliar office. The assessment happens in whatever space works for you.
• Training. B.A. from Stanford, Ph.D. from Ferkauf Graduate School of Psychology at Yeshiva University.

Frequently asked questions about adult Autism assessments

If you want to talk about it

If you have been circling this question for a while, a short conversation costs you nothing and usually clarifies whether an assessment is the right next move. Email me and we will set up a free 15-minute call.